At the beginning of his term, the President of Mexico announced that we would have a healthcare system like Denmark. Voluntarism aside, for any comparison, one must first know, on the basis of hard data, both realities in relation to health.
I take data from the most recent Organization for Economic Co-operation and Development (OECD) health study Health at a Glance (2021). Most of the data is from 2019, before the Covid-19 pandemic, which could indicate worsening performance.
Life expectancy at birth was 81.5 years in Denmark and 75.1 years in Mexico.
In Denmark, preventable deaths from preventable and treatable causes per 100,000 inhabitants was 167; in Mexico, more than twice: 366. If this figure is above 300 per 100,000 population, then there is a deterioration in health: this is our case.
Over the past twenty years, deaths from heart attacks in Denmark have decreased by 72 percent; in Mexico they increased by 23 percent.
Infant mortality in Denmark is three cases per thousand births, in Mexico – 13.1 deaths.
In Denmark, over the past two years, 83.2 percent of women have had mammograms, while in Mexico, 45.4 percent.
The overweight or obese population over 15 in Denmark has reached 48.8%; Mexico registers the worst situation in the OECD with 75.2 percent. Obesity leads to chronic diseases such as diabetes, cardiovascular disease and cancer.
In Denmark, 100 percent of the population had access to health care; in Mexico, 20 percent did not have this right in 2019. (The situation has worsened, as Coneval showed in 2020: 35.7 million Mexicans had no access to the -19 pandemic, 15 million more than those who did not have access in 2018. And ENIGH 2022 shows what households spend on healthcare 30.9 percent more than in 2018: in fact, under this government, privatization of healthcare is moving forward).
Prepaid health services in Denmark covered 83.3 percent of the population, in Mexico only 49.3 percent. Here, people spend on health when they get sick or have an accident, which causes catastrophic spending and impoverishment. In Denmark, whoever has the most does the most, and whoever needs the most gets the most. Here the needy pays.
The OECD report presents the balance of the Covid-19 pandemic in 2020-2021. The excess mortality per million population was 195 in Denmark; in Mexico, more than twenty times that: 4,456, indicating that the healthcare system has collapsed due to the pandemic and other conditions have gone untreated. In Denmark, mortality as of June 2021 compared to the average for 2015-2019 increased by 1.38 percent; in Mexico, 55 percent. Of course, the vaccination rate in the European country was 75.3 percent, while in Mexico it was only 35.4 percent.
The difference in health care is due to the availability of infrastructure and resources. In Denmark, there are 2.6 hospital beds, 4.2 doctors and 10.1 nurses for every thousand people; Mexico has one bed, 2.4 doctors and 2.9 nurses for every 1,000 inhabitants. In Denmark, 100 percent of primary care physicians maintain electronic records, here only 30 percent.
The contrasts are due to the asymmetry of investments in health: the Danes allocate 10 percent of GDP to health care; Mexicans 5.4 percent. Denmark spends $5,478 a year per person (purchasing power parity), while Mexico spends a quarter: $1,133. In Denmark, 83 percent of health care spending is funded directly by the government, while in Mexico it is only 27 percent. Here, 22 percent of spending is financed by employers’ and employees’ social security contributions, so more than half of healthcare spending is privately owned by patients and their families. While in Denmark one can speak of a universal public health system, in Mexico access to health care is basically a market transaction.
Mexico allocates less than 3.0 percent of GDP for public health spending; Denmark over 8.0 percent.
Increasing tax collection and spending, strengthening health institutions, avoiding system fragmentation, and investing in knowledge, infrastructure and qualified personnel are important steps to improve the health system.
But this government in Mexico abandoned redistributive fiscal reform, destroyed the Seguro Popular, further fragmented the healthcare system, and ignored medical knowledge. This took us away not only from Denmark, but also from Mexico, which is possible and desirable.
The author is an economist, UNAM professor.